Vertebral metastases of functional vaginal paraganglioma treated with radiation therapy: A case report

Abstract

Paragangliomas, also known as extra-adrenal pheochromocytomas, are very rare and slowly growing tumors of the autonomous nervous system, which hardly ever metastasize. Thus far, eight cases on vaginal paraganglioma have been reported. In 2005, a 17-year old female patient was first diagnosed with a functional vaginal paraganglioma, which was then successfully operated on. Thirteen years later, the patient was hospitalized due to a hypertensive crisis. The diagnostic work-up revealed recurrence of the tumor with metastases in the lungs and spine. The patient underwent pelvic and thoracic surgery before being referred for radiation treatment. This is the first case report describing radiotherapy for a spinal metastasis of a functional vaginal paraganglioma by intensity-modulated radiotherapy with simultaneous integrated boost (SIB-IMRT). A total dose of 50 Gy in 2,5 Gy fractions to the PET positive lesions and 40 Gy in 2 Gy fractions to the whole vertebral body was delivered. The treatment was excellently tolerated and local tumor control was achieved.

Keywords

• Pheochromocytoma
• Catecholamines
• Vertebral metastasis
• Radiotherapy
• IMRT
• Simultaneous integrated boost